Widespread unilateral pain associated with herpes simplex virus infections

The Journal of Pain : Official Journal of the American Pain Society
Katariina Kallio-LaineEija Kalso

Abstract

We describe a patient group with unexplained widespread pain on one side of the body and pain exacerbations during active labial or genital herpes and during herpetic central nervous system infections. The patients had no visible lesion of the central nervous system on magnetic resonance imaging or abnormality in electrophysiological studies. To understand the nature of the pain and its possible relation to herpes simplex virus (HSV) infections, a clinical neurological examination was performed and quantitative sensory testing and skin biopsies were assessed in 17 patients. The levels of serum total immunoglobulins and IgG subclasses and the frequencies of the immune response genes at the IGH@, HLA-A, -B, -DRB1, C4A, and C4B loci were analyzed in the patients and in control subjects. The patients manifested a uniform clinical syndrome with unilateral pain that was best described as neuropathic and that was exacerbated by HSV reactivations. Low plasma IgG3 concentrations, the presence of either low plasma IgG1 or IgG3 or both, and high anti-HSV-2-IgG titers were more common in the patients than in the control subjects, which rendered the patients more vulnerable to HSV recurrences. We suggest that low immunoglobulin subclass lev...Continue Reading

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Citations

Jul 13, 2011·Dermatology Research and Practice·Catriona Ooi, Vijay Zawar
Nov 19, 2013·Pharmacogenomics·Calvin LeungG Gregory Neely
Jul 25, 2009·Expert Review of Vaccines·Gargi DasguptaLbachir BenMohamed
Dec 20, 2015·Experimental Neurology·Rebekah A Warwick, Menachem Hanani
Dec 20, 2014·European Journal of Pain : EJP·E KirveskariN Forss
Jul 30, 2009·The Journal of Pain : Official Journal of the American Pain Society·Nuutti VartiainenNina Forss
May 5, 2020·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Gilles LavigneJean-Francois Masse

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